[Family anamnesis, cholecystectomy and gastric resection in patients with colorectal carcinoma: a case-control study]. / Anamnesi familiare, colecistectomia e gastroresezione in pazienti con carcinoma colorettale: studio caso-controllo.

An increased risk of colorectal cancer has been reported in first-degree relatives of affected patients, and following cholecystectomy or partial gastrectomy for benign peptic ulcer disease. The aim of this study was to examine the incidence of these potential risk factors in 197 patients (127 males, 70 females, mean age 70 years +/- 10.9, range 22-94 years) with cancer of the large bowel and 202 controls (91 males, 111 females, mean age 68 years +/- 14.06, range 17-93 years) who underwent a total colonoscopy, that revealed no colorectal neoplasms. No significant differences were found between the case and control group for a past history of cholecystectomy or gastric surgery, respectively reported by 14 and 12 patients of group 1 and 18 and 8 patients of group 2. Patients with large bowel cancer show a significant excess of both colorectal (21.31% vs 11.9%) and extracolonic malignancies (46.19% vs 26.73) in first degree relatives (p < 0.05). In approximately 7% of them the aggregation of two or more colorectal cancers among relatives is suggestive for a hereditary form of large bowel cancer.

Papillary thyroid carcinoma in three siblings with familial adenomatous polyposis.

The authors report three siblings (two sisters and their aunt, aged 20, 22 and 36, respectively) with familial adenomatous polyposis (FAP) and papillary thyroid carcinoma. After diagnosis of FAP, a single, non palpable nodule was revealed in each patient by routine screening ultrasonography of the gland. The diagnosis of papillary carcinoma was made by fine-needle-aspiration biopsy of the nodules and confirmed by histologic examination of surgical specimens. A review of the literature reveals about 40 reports of such an association, that is considered not fortuitous. Nevertheless, in this family the association seems to be a distinctive, clinical feature of the syndrome, affecting three out of five members intensively screened for extracolonic lesions.

[Heredity and colorectal cancer]. / Ereditarietà e cancro colorettale.

Colorectal cancer is the second leading cause of death from malignancies in Western Countries. In spite of advances in treatment, little change in survival has been accomplished in last decades and this mandates greater importance to prevention and early detection. Although dietary factors have received primary attention familial clustering suggests that susceptibility to KCR is inherited. Hereditary colorectal cancer can arise on Familial Adenomatous Polyposis (HCC) or not on polyposis (HNPCC) and members of these families are at high risk of such neoplasias. Anyway, even in "sporadic" forms of KCR first-degree relatives have a 2 to 3-fold increased risk of the same cancer. The most desirable screening protocol would be a simple procedure involving only a blood test to identify gene defect by molecular biology techniques. Unfortunately, this is not practically possible, for lack of specific genetic alterations, out of FAP, and only the study of family history can enable targeted surveillance and cost-effective management strategies.

[Update on epidemiology and risk factors of colorectal carcinoma]. / Attualità in tema di epidemiologia e fattori di rischio del carcinoma colo-rettale.

Etiology of colorectal cancer is not completely clear. Epidemiologic studies, especially those on migrant populations, demonstrate the importance of environmental factors, particularly dietary, in cancerogenesis. Anyway, familial aggregation within a given population shows that genetic factors play an important role. General risk factors are represented by age, sex, physical activity... while some pathologies increased the risk of developing KCR or are frankly precancerous (adenomas, ulcerative colitis, Crohn's disease...).

[Blood gastrin and colorectal neoplasms]. / Gastrinemia e neoplasie colorettali.

Gastrin has a trophic effect on the mucosa of the gastrointestinal tract and seems to have the potential for promoting colonic cancerogenesis through a chronic stimulation of the epithelial proliferation. Plasma gastrin has been reported to be elevated in patients with colorectal neoplasms. The aim of the present study was to verify this observation. Presurgical serum levels of gastrin were compared between 49 patients with colorectal neoplasms and 47 controls hospitalized for other surgical lesions. Results show significantly higher gastrin levels of case group than controls: 72.72 + 85.41 vs. 46.79 + 24.09 pg/ml (p < 0.05), and provide support for the hypothesis of a gastrin-stimulated neoplastic growth enhancing at the same time the potential therapeutic role of reducing gastrin secretion.